In Reply: Drs Amundson and Isham raise a useful
question on the presentation of performance data. We believe that there is
no single correct way to present these data. Although we used a presentation
that we expected would be useful to readers, Amundson and Isham's approach
may be more useful in demonstrating the magnitude of the problem. A limitation
of their approach is that it can be relatively insensitive to progress. If,
for example, the number of patients with pneumonia who receive prompt treatment
and appropriate antibiotics improves sharply but there is no improvement in
immunization rates, their indicator would fail to reflect this improvement.